In this section
Note: This guideline is currently under review.
Definition of terms
Anaesthetic and surgical staff are often presented with children who have recently been immunised, for either emergency or elective surgery. Although there is no direct evidence of any major interaction between immunisation and commonly used anaesthetic agents and techniques in children, it is possible that the anaesthesia or surgery may affect the immune response of the vaccine. It is also possible that the systemic effects from immunisation, such as fever, may confuse the clinical management of the patient during the post-operative period. It is therefore important that an immunisation history is undertaken prior to surgery.
The aims of this guideline are:
As both anaesthesia and surgery may impair the immune system, there is the theoretic risk of altered response to vaccines if surgery is performed in close proximity to vaccine administration In general, immunisation should not be administered during general anaesthesia, in order that paracetamol or other anti-inflammatory agents can be used freely as part of the anaesthetic technique and post-surgical care. If it is indicated immunisation should be given when the child has recovered, but before discharge.
However, there may be circumstances where vaccination under general anaesthesia may be the best option for the patient. Specifically:
In situations where intra-operative vaccination is required, this is to be negotiated with the Royal Children’s Hospital (RCH) Immunisation Centre nursing staff and the surgical staff prior to the patient entering the Operating Suite. This can be via the Nursing Care Coordinator (e.g. Complex care team, Pre-admission Resource centre). Steps:
All vaccines administered to patients should be documented in the patient’s EMR and the individual child health record or immunisation record card.
RCH Immunisation Drop-in Centre opens from 9:00am - 4:30pm Monday to Friday (except public holidays). Phone: 93454899
Diphtheria-tetanus-acellular pertussis (whooping cough)
Haemophilus influenzae type b
Immunisation and Anaesthesia Evidence Table
Please remember to read the
The development of this clinical guideline was coordinated by Sonja Elia, Nurse Practitioner, Immunisation . Approved by the Clinical Effectiveness Committee. Updated August 2020.